Written Answers

Wednesday 26 April 2000

Scottish Executive

Cancer

Kay Ullrich (West of Scotland) (SNP): To ask the Scottish Executive what plans it has to increase funding for the treatment of cancer patients in order to address the concerns recently highlighted by Professor Gordon McVie, Director General of the Cancer Research Campaign.

Susan Deacon: Cancer is one of three clinical priorities for the NHS in Scotland.

  A great deal of work is already underway to meet the aims set out in Towards a Healthier Scotland and Designed to Care. This includes targeted health promotion programmes, earlier detection via existing screening programmes and a pilot colorectal cancer screening programme. Real improvements in care, centred on patients’ needs will be brought about by a variety of means, led by the Scottish Cancer Group, including:

  the establishment of managed clinical networks of care underpinned by;

  robust quality assurance/prospective audit systems;

  the development and subsequent assessment of clinical standards for cancer services by the Clinical Standards Board for Scotland;

  new ways of targeting waiting times to speed up diagnosis and treatment.

  On top of the record funding of £5.2 billion in 2000-01 and £5.5 billion in 2001-02 already committed by the Scottish Executive to health in Scotland, as announced in the Scottish Parliament on 30 March, a further £173 million will be added to the Health Budget in 2000-01, with further major increases each year up to 2003-04. £12.5 million has already been committed to fund new linear accelerators for radiotherapy treatment. Approximately £1 billion is provided across the UK to support cancer research. The Scottish Executive funds targeted to research and clinical effectiveness programmes currently amount to £6.2 million. Starting in 2001 for three years, the New Opportunities Fund cancer initiative will provide £17.5 million additional resource for innovative programmes across Scotland.

Cancer

Mr Kenneth Gibson (Glasgow) (SNP): To ask the Scottish Executive what preventative action it is taking to reduce the incidence of cancer.

Mary Scanlon (Highlands and Islands) (Con): To ask the Scottish Executive what plans are in place to increase preventative action to help reduce the rising rates of cancer.

Susan Deacon: The Scottish Executive is determined to face the challenges posed by cancer. We have pledged to tackle the root causes of ill health and work over the next 10 years to promote healthier living and reduce mortality from cancer by 20%.

  Specific initiatives designed to address these pledges and the Scottish Executive’s approach to public health generally are set out in the White Paper, Towards a Healthier Scotland, a copy of which has been placed in SPICe.

  This is a challenging and wide ranging programme including:

  additional investment of £1 million to aid smoking cessation programmes;

  promoting healthier lifestyles and diet including the appointment of a Scottish Diet Co-ordinator;

  establishment of Healthy Living Centres via the New Opportunities Funding initiative (£34.5 million);

  The Cancer Challenge – a pilot programme to test the feasibility of a national screening programme for earlier detection of colorectal cancer;

  a formalised cancer genetics programme for breast, colorectal and ovarian cancer to provide advice and counselling for individuals who may be at increased risk based on their family history.

  The substantial additional investment in public health and health promotion, announced in the Scottish Parliament on 22 March, will further strengthen our efforts to help reduce the incidence of cancer in Scotland.

Cancer

Kay Ullrich (West of Scotland) (SNP): To ask the Scottish Executive what is the average waiting time for cancer patients to receive radiotherapy treatment, following diagnosis, broken down by health board area for 1998-99 and to date in 1999-2000.

Susan Deacon: Cancer is one of the top clinical priorities for the NHS in Scotland.

  One aspect of this strategic priority is to improve information about cancer and its treatment within the NHS in Scotland. Therefore, since 1 January 1997 the Scottish Cancer Registry has recorded details of all patients registered since that time who receive radiotherapy treatment within six months of diagnosis (see note below), and the mean and median time in weeks between diagnosis and the start of this treatment. These data for 1997 are set out in the table attached.

  These data must be interpreted with caution.

  The date of diagnosis is taken to be the date of first consultation at, or admission to, hospital for the cancer in question.

  No distinction can be made between curative and palliative treatment.

  Assumptions cannot be made about the apparent variations in the interval between the (assumed) date of diagnosis and date of first radiotherapy treatment, as this may reflect a variety of planned treatment decisions and circumstances, including sequencing of different modalities of treatment and the first manifestation of metastatic disease requiring radiotherapy, which can be many weeks after first diagnosis.

  Cancer registration data are collected retrospectively and 1997 is the most recent completed year currently available.

  The reduction of waiting times for cancer investigation and treatment is a high priority within the Scottish Cancer Group’s work programme.

  Number of cancer patients receiving radiation treatment within six months of diagnosis1, the mean and median time (in weeks) between diagnosis and start of this treatment, by health board of residence, 19972

  


Health Board


Total number 
  of cases of cancer registered for 19973


Total number 
  commencing radiotherapy within six months of diagnosis4


Mean


Median




Argyll & Clyde
  

2,060
  

462
  

10.7
  

9.1
  



Ayrshire and Arran
  

1,956
  

381
  

10.8
  

9.9
  



Borders
  

560
  

107
  

10.4
  

9.1
  



Dumfries & Galloway
  

736
  

146
  

12.5
  

12.0
  



Fife
  

1,583
  

405
  

10.9
  

10.1
  



Forth Valley
  

1,197
  

249
  

10.0
  

9.1
  



Grampian
  

2,315
  

608
  

8.0
  

6.3
  



Greater Glasgow
  

4,468
  

877
  

10.8
  

9.7
  



Highland
  

1,174
  

304
  

7.2
  

5.7
  



Lanarkshire
  

2,221
  

526
  

10.3
  

9.4
  



Lothian
  

3,411
  

705
  

10.6
  

9.7
  



Orkney
  

97
  

19
  

7.4
  

5.3
  



Shetland
  

86
  

26
  

7.6
  

7.0
  



Tayside
  

2,053
  

519
  

9.4
  

8.1
  



Western Isles
  

174
  

44
  

6.4
  

4.7
  



Scotland5


24,093
  

5,378
  

10.0
  

8.9
  



  Notes:

  1. Date of diagnosis is taken to be date of first consultation at or admission to hospital for the cancer in question.

  2. Based on 1997 cancer registration data – provisional figures.

  3. The Scottish Cancer Registry aims to collect information on initial treatment, given within the first six months of diagnosis.

  4. All invasive cancers excluding non-melanoma skin cancer (ICD-10 C00-C97 excluding C44).

  5. This includes two cases with health board not known at present.

Cancer

Mr Keith Harding (Mid Scotland and Fife) (Con): To ask the Scottish Executive whether it will publish the number of surgeons and oncologists specialising in lung cancer for each health board.

Susan Deacon: Centrally collected data includes numbers of surgeons and oncologists employed in the NHS in Scotland. Recognised specialist/specialty functions are identified, for example, urological surgery, plastic surgery, ear/nose and throat surgery. Tumour specific interests are not in themselves a separate and distinct specialty and this information is not therefore available.

  Some surgeons do seek to sub-specialise or have a special interest in disease-specific areas but, in general, surgical treatment of lung cancer is undertaken by cardiothoracic and/or general surgeons.

  Similarly, some oncologists may have a special interest in specific tumour types but, in general, provide oncology services for all patients with cancer regardless of tumour type.

  Table 1 attached shows the number of consultants in cardiothoracic surgery and general surgery, by health board and by whole time equivalent (WTE) posts and numbers of staff at 30 September 1999.

  The numbers of consultant clinical and medical oncologists employed at each of the Trusts containing the five specialist cancer centres in Scotland were previously provided in response to question S1W-2232 on 29 November 1999.

  Table 1: Consultants in cardiothoracic surgery and general surgery by health boards at 30 September 1999.p

  


 


WTE


Headcount




 


General surgery


Cardiothoracic 
  surgery


Total


General surgery


Cardiothoracic 
  surgery


Total




Totals
  

 184.0
  

 20.3
  

 204.3
  

 200
  

 22
  

 222
  



Ayrshire and Arran
  

 11.0
  

- 
  

 11.0
  

 11
  

- 
  

 11
  



Borders
  

 4.0
  

- 
  

 4.0
  

 4
  

- 
  

 4
  



Argyll and Clyde
  

 14.5
  

- 
  

 14.5
  

 15
  

- 
  

 15
  



Fife
  

 10.5
  

- 
  

 10.5
  

 13
  

- 
  

 13
  



Greater Glasgow
  

 37.2
  

 11.3
  

 48.4
  

 40
  

 13
  

 53
  



Highland
  

 11.0
  

- 
  

 11.0
  

 11
  

- 
  

 11
  



Lanarkshire
  

 17.3
  

 2.0
  

 19.3
  

 20
  

 2
  

 22
  



Grampian
  

 15.6
  

 3.0
  

 18.6
  

 16
  

 3
  

 19
  



Orkney
  

 2.0
  

- 
  

 2.0
  

 2
  

- 
  

 2
  



Lothian
  

 29.1
  

 4.0
  

 33.1
  

 34
  

 4
  

 38
  



Tayside
  

 17.8
  

- 
  

 17.8
  

 20
  

- 
  

 20
  



Forth Valley
  

 8.0
  

- 
  

 8.0
  

 8
  

- 
  

 8
  



Western Isles
  

 1.0
  

- 
  

 1.0
  

 1
  

- 
  

 1
  



Dumfries and Galloway
  

 4.0
  

- 
  

 4.0
  

 4
  

- 
  

 4
  



Shetland
  

 1.0
  

- 
  

 1.0
  

 1
  

- 
  

 1
  



  Source: Medical and Dental Manpower Census, ISD Scotland, Ref. 2000/0183.

  p - provisional

Charities

Phil Gallie (South of Scotland) (Con): To ask the Scottish Executive how much public funding the charity "Gay Men’s Health" receives annually and what the purpose of this public funding is.

Iain Gray: In 1998-99, Gay Men’s Health received funding of £101,146 from Lothian Health Board in support of its work to promote sexual health, including HIV prevention, among gay men.

Dental Care

Irene Oldfather (Cunninghame South) (Lab): To ask the Scottish Executive whether it will provide details of any plans it has to provide extra funding for methods of anxiety control, other than dental general anaesthesia, for dental patients.

Susan Deacon: The main alternative means of treating dentally-anxious patients is sedation. The Scottish Council for Postgraduate Medical and Dental Education runs courses on sedation for general dental practitioners. The number of courses provided depends on demand and there are no indications at present that demand exceeds supply. The Scottish Executive is continuing to monitor the situation.

Drug Misuse

Fiona McLeod (West of Scotland) (SNP): To ask the Scottish Executive what progress has been made in relation to improving the range and quality of drug services for young people, particularly under 16s, in the last year and how many more under 16s with drug problems are now receiving an "appropriate service" compared with 12 months ago.

Angus MacKay: The information requested on the numbers of under 16s receiving an "appropriate service" is not available centrally. However, the following table presents for 1997-98 to 1999-2000, the number of new individuals aged less than 16 years reported to the Scottish Drug Misuse Database.

  


Number of new individuals 
  attending services1



 

1997-98
  

1998-99
  

1999-20002




Under 16 years
  

108
  

119
  

102
  



  Notes

  1. The definition of "new" is (a) the person is attending the particular service for the first time ever or (b) the person has attended before but not within the previous six months.

  2. Provisional data for the first nine months of 1999-2000.

  Information available from Drug Action Teams (DATs) suggest that 32% have specialist services targeted at young people in their areas. In addition, some services are available within mainstream adult services.

Drug Misuse

Fiona McLeod (West of Scotland) (SNP): To ask the Scottish Executive what progress has been made in relation to increasing access to drug information and drug services for "vulnerable groups" in the last year and how many more "vulnerable" young people are now receiving an "appropriate service" compared with 12 months ago.

Angus MacKay: The information requested on the number of "vulnerable" young people receiving an "appropriate service" is not available centrally.

  Information available from Drug Action Teams (DATs), however, suggests that drug misuse information and advice services to "vulnerable" young people is being provided in the majority of DAT areas.

Emergency Services

Trish Godman (West Renfrewshire) (Lab): To ask the Scottish Executive, further to the answer to question S1W-4617 by Angus MacKay on 3 April 2000, how much it estimates responding to malicious false alarm calls to the emergency services cost each of the emergency services in each of the last four years.

Mr Jim Wallace: The available information is as follows:

  Scottish Ambulance Service

  


Year
  

Inverclyde (£)
  

Renfrewshire (£)
  

Scotland (£)
  



1995-96
  

487
  

975
  

117,681
  



1996-97
  

1,568
  

4,052
  

131,263
  



1997-98
  

2,195
  

3,430
  

142,170
  



1998-99
  

2,192
  

3,974
  

134,299
  



  Fire Service

  The cost to the fire service of responding to emergency calls varies widely according to the number and type of firefighters and appliances mobilised on each occasion. Taking staff and running costs into account, the approximate total cost of responding to malicious false alarm calls in Scotland in each of the last four years is estimated at:

  


1995-96
  

£750,000
  



1996-97
  

£738,000
  



1997-98
  

£687,000
  



1998-99
  

£666,000
  



  Police Service

  Police Forces rely on the expertise of their control room staff to obtain and disseminate sufficient information to ensure an appropriate level of response to emergency calls. The information required to estimate the costs of responding to malicious, hoax and false calls is not available.

Epilepsy

Mr Kenneth Gibson (Glasgow) (SNP): To ask the Scottish Executive what steps it will take to ensure all people with epilepsy obtain an annual assessment at a specialist unit to check whether they still have the condition.

Susan Deacon: The NHS in Scotland is committed to ensuring that the highest quality of care is provided to all patients. It is important that patients with chronic conditions such as epilepsy, who may be on long-term drug treatment, are regularly reviewed. The frequency of such reviews is a matter for the clinical judgement of the relevant consultant. Existing national clinical guidelines published by Scottish Intercollegiate Guidelines Network in 1997 on The Diagnosis and Management of Epilepsy in Adults are scheduled for review this year.

European Convention on Human Rights

Mr Keith Harding (Mid Scotland and Fife) (Con): To ask the Scottish Executive what impact the European Convention on Human Rights will have on local authority licensing boards.

Mr Jim Wallace: The Scottish Executive is reviewing systematically all its activities in order to ensure compliance with the European Convention on Human Rights. The local authorities will similarly require to identify issues where there is a risk of challenge.

Food Standards Agency

Mrs Margaret Ewing (Moray) (SNP): To ask the Scottish Executive what responsibilities it will have for the work of the Food Standards Agency; whether these responsibilities differ in any way from those set out in the Department of Health’s letter of 29 March 2000 to MPs; whether it received a copy of that letter and, if so, what response was given.

Susan Deacon: The Food Standards Agency will be fully accountable to the Scottish Parliament through Scottish Ministers. Scottish Ministers will also have overall responsibility for determining policy on food safety and standards issues that are devolved and for making Scottish legislation.

  The letter from the Parliamentary Under-Secretary of State for Health to Westminster MPs did not require a response from the Scottish Executive. Specific details of the continued handling of the Scottish Parliament’s business relating to the agency will be provided shortly to members.

Health

Mr David Davidson (North-East Scotland) (Con): To ask the Scottish Executive whether it has any plans to introduce pilot schemes to allow greater prescribing of drugs and medicines by pharmacists.

Susan Deacon: A Project Board has been formed to take forward the planning of this initiative which I announced on 8 November 1999 in my speech to the National Symposium on "Pharmacy and the NHS in Scotland". Our intention is to have pilot schemes up and running by the end of this year, which will allow community pharmacists to supply to specific patients, direct and free of charge, certain Pharmacy and General Sales List medicines which would otherwise have been obtained on prescription from a GP.

Health

Robert Brown (Glasgow) (LD): To ask the Scottish Executive what its policy is on the prescribing of the drug Rilutek to sufferers of motor neurone disease; whether it supports the prescribing of the drug by Lanarkshire Health Board, and whether it has any plans to make the drug available to sufferers in other health board areas.

Susan Deacon: Treatment with Rilutek should only be initiated by specialist physicians experienced in the management of motor neurone disease and patients' eligibility for this treatment depends on the clinical judgement of the medical practitioners' concerned.

  It is for each health board to determine its prescribing policy on drugs, including Rilutek, taking into account advice from local drug and therapeutic committees. When the Health Technology Board for Scotland, established on 1 April begins work this summer, health boards will have access to a single focus of advice on the clinical and cost-effectiveness of health technologies, including drugs.

Health

Kay Ullrich (West of Scotland) (SNP): To ask the Scottish Executive whether it has considered the recommendations of the organisation C Change with regard to pre- and post-test counselling in relation to hepatitis C.

Susan Deacon: In 1999, The Scottish Office commissioned the Scottish Needs Assessment Programme to establish a working group to consider all aspects of hepatitis C including epidemiology, prevention, investigations and treatment, and to estimate future implications for the Scottish population and for service needs.

  The report’s conclusions will be considered alongside the views of other bodies, including C Change. It is expected the working group’s report will be published in the summer.

Health

Kay Ullrich (West of Scotland) (SNP): To ask the Scottish Executive what its estimate is of the prevalence of the hepatitis C virus in Scotland.

Susan Deacon: Preliminary analyses of existing data held by the Scottish Centre for Infection and Environmental Health (SCIEH) suggest that around 35,000 persons alive in Scotland have been infected with hepatitis C as at March 2000 and that the great majority of these will be asymptomatic carriers of the virus. SCIEH estimates that approximately 10,000 people will have been diagnosed and reported as being infected by the end of 1999.

Health

Linda Fabiani (Central Scotland) (SNP): To ask the Scottish Executive when it last made representations to the Department of Trade and Industry regarding any changes to health services in Scotland as a result of the recent World Trade Organisation talks.

Susan Deacon: Neither the Scottish Executive nor the Department of Trade and Industry anticipate any changes to health services as a result of current World Trade Organisation (WTO) discussions, either under the General Agreement on Trade in Services (GATS) or under the Government Procurement Agreement (GPA). GATS does not apply to services provided by central or local governments nor to services provided in the exercise of government authority. Similarly, the GPA does not apply to contracts for the procurement of health services. The Scottish Executive has not, therefore, considered it necessary to make any representations to the Department of Trade and Industry on this subject.

Health

Nora Radcliffe (Gordon) (LD): To ask the Scottish Executive what guidance and training is currently in place to inform GPs about the problem of abuse of vulnerable adults.

Nora Radcliffe (Gordon) (LD): To ask the Scottish Executive whether it plans to issue further guidance or training to GPs in order to address the problem of abuse of vulnerable adults.

Susan Deacon: Abuse of vulnerable adults can take a variety of forms, but are generally of a psychiatric or psychological nature, whether in relation to the victim or to the abuser.

  Psychiatry and psychology form a strong element in the training of general practitioners and a significant proportion of them have specific training in psychiatry. However, it is in the nature of general practice that doctors develop expertise in caring for vulnerable adults and other groups with special needs as part of their continuing professional development (CPD). The responsibility lies with individual doctors to seek training in specific areas as dictated by their personal learning needs and by the health needs of their patients. The Scottish Council for Postgraduate Medical and Dental Education (SCPMDE) provides assistance and guidance for CPD via the regional Postgraduate Directors of General Practice Education and each GP receives an annual Postgraduate Education Allowance to support an agreed amount of training.

Health

Christine Grahame (South of Scotland) (SNP): To ask the Scottish Executive how many deaths as a consequence of hypertrophic obstructive cardiomyopathy there have been in each of the last five years and how these figures are compiled.

Susan Deacon: The information is in the following table:

  Numbers of deaths where the underlying cause of death was recorded as hypertrophic obstructive cardiomyopathy (ICD 425.1*)

  


1995
  

11
  



1996
  

11
  



1997
  

5
  



1998
  

6
  



1999 (provisional)
  

6
  



  *Deaths in Scotland for the years to 1999 were coded to the World Health Organisation's International Classification of Diseases Ninth Revision (ICD9). The Tenth Revision (ICD10) is being used for deaths registered since 1 January 2000.

  For every death, a doctor has to complete a medical certificate of cause-of-death. The "informant" (the person, generally a relative of the deceased, who has the duty of giving information to the local registrar of births, deaths and marriages to enable the death to be formally registered) hands over this medical certificate to the registrar who transcribes the cause-of-death details on to the register entry. Local registrars generally capture register-entry information electronically (now 96%) and send it to the Registrar General in Edinburgh, who compiles Scotland’s cause-of-death statistics. Cause-of-death figures for 1998 and earlier years are available on the website of the General Register Office for Scotland, http://www.gro-scotland.gov.uk. The Registrar General makes an annual report each summer to the Parliament for the preceding calendar year, including cause-of-death information. The Registrar General sent a paper copy of his most recent (1998) Annual Report to each MSP last summer, after it was published on 27 July 1999.

Justice

Euan Robson (Roxburgh and Berwickshire) (LD): To ask the Scottish Executive whether it will extend the witness schemes originally piloted in Ayr, Kirkcaldy and Hamilton Sheriff Courts to Sheriff Courts in the Scottish Borders.

Mr Jim Wallace: I was pleased to announce in December 1999 an additional £2 million to extend the witness service to Sheriff Courts across Scotland, including the Scottish Borders, over the next three years.

Knowledge Economy

Allan Wilson (Cunninghame North) (Lab): To ask the Scottish Executive, further to the answer to question S1W-4719 by Donald Dewar on 21 March 2000, what measures it intends to employ to integrate its policy strategy in the areas identified by the Joint Action Committee on the knowledge economy with strategy at a UK level.

Donald Dewar: Policy and action on the knowledge economy will be co-ordinated through the work of the Joint Ministerial Committee (Knowledge Economy) and through the normal, regular contact between the Scottish Executive and officials in the relevant UK Government Departments.

Legal Aid

Maureen Macmillan (Highlands and Islands) (Lab): To ask the Scottish Executive what the Scottish Legal Aid Board’s criteria are for granting legal aid for an interdict under the Matrimonial Homes (Family Protection) (Scotland) Act 1981, and how many times it has refused to grant legal aid and on what grounds.

Mr Jim Wallace: As with all civil legal aid applications, the board will grant civil legal aid for an interdict under the Matrimonial Homes (Family Protection) (Scotland) Act 1981 if the application satisfies three statutory tests. The tests are financial eligibility, probable cause of action and reasonableness.

  The board does not maintain a full separate record of civil legal aid applications for interdict under the 1981 Act.

Mental Health

Mary Scanlon (Highlands and Islands) (Con): To ask the Scottish Executive what percentage of mental health spending is allocated to (a) institutionalised care and (b) care in the community.

Iain Gray: Health boards and local authority Social Work Departments incur expenditure in relation to mental health.

  Health boards receive an allocation based on weighted capitation. They are then required to provide a Health Improvement Plan in conjunction with their partner Trusts to meet the health requirements of their resident population, in line with national priorities.

  In terms of NHS expenditure, mental illness is equated with the specialties of General Psychiatry, Adolescent Psychiatry, Child Psychiatry and Geriatric Psychiatry.

  The information provided in the following table groups the expenditure for inpatients, outpatients and day patients to provide a total hospital figure. The expenditure figures are for 1998-99 which are the latest available.

  


Health Board Expenditure 
  on Mental Illness
  



Year
  

Total
  

Hospital
  

Community
  

Hospital
  

Community
  






£ million
  

£ million
  

£ million
  

%
  

%
  



1998-99
  

415
  

377
  

38
  

91%
  

9%
  



  Source: Scottish Health Service Costs 1998-99.

  Health boards report actual expenditure. The information available from health boards regarding expenditure on mental illness treatment is provided on the basis of patient category i.e. inpatient, outpatient, day patient and community.

  The health board expenditure reflects the costs of services purchased, and may not equate exactly with the cost of treatment for mental illness.

  The following table details the breakdown of net revenue expenditure by social work departments on mental health services. 1997-98 is provided as a detailed breakdown and is not available for more recent years.

  


Local Authority 
  Social Work Expenditure on Mental Health 1997-98 (£ million)
  



 


Net Expenditure
  

% of Total
  



Residential & Nursing Homes
  

5.9
  

20%
  



Day Centres
  

7.1
  

23%
  



Other Services
  

17.1
  

57%
  



Total
  

30.1
  






  Source: As reported by local authorities on local financial returns (LFR3 Social Work).

Mental Health

Mary Scanlon (Highlands and Islands) (Con): To ask the Scottish Executive how much was spent on mental health in (a) 1999-2000, (b) 1998-99 and (c) 1997-98.

Iain Gray: Health boards and local authority Social Work Departments incur expenditure in relation to mental health.

  In terms of NHS expenditure, mental illness is equated with the specialties of General Psychiatry, Adolescent Psychiatry, Child Psychiatry and Geriatric Psychiatry.

  The figures for 1997-98 and 1998-99 are provided in the publication Scottish Health Service Costs for each of the years. Figures relating to expenditure by health boards are not yet available for 1999-2000.

  The following table sets out the net revenue expenditure by local authority social work departments on services for people with mental health problems. The source of data for 1997-98 is different to that for 1998-99 and 1999-2000. Care should be taken when making comparisons as the categories in which expenditure data are collected are different for these two sources.

  


Local Authority 
  Social Work Expenditure on Mental Health 1997-98 to 1999-2000
  (£ million)







1997-98
  

1998-99
  

1999-2000
  









Provisional Outturn
  

Budget Estimate
  



Net Expenditure
  

30.1
  

33.5
  

36.8
  



  Source: 1997-98 Figures as reported by local authorities on local financial returns (LFR3 Social Work). 1998-99 and 1999-2000 as reported by local authority on Provision Outturn Budget Estimate (POBE) returns.

Multiple Sclerosis

Dorothy-Grace Elder (Glasgow) (SNP): To ask the Scottish Executive, further to the answer to question S1W-1852 on 11 February 2000 by Susan Deacon, why it has not taken any steps to gather information on, and compile a national register of, multiple sclerosis sufferers who may benefit from beta interferon treatment.

Susan Deacon: The Scottish Needs Assessment Programme (SNAP) has established a working group to assess the total needs of people with multiple sclerosis. The group is expected to report in May and their report will include a chapter on epidemiology.

  Only certain patients with a diagnosis of multiple sclerosis are likely to benefit from the use of beta interferon and patients' eligibility for this treatment depends on the clinical judgement of the clinicians concerned. Because of the variable and unpredictable natural history of multiple sclerosis, a register which identified individuals who may benefit from beta interferon treatment would not be feasible.

NHS Funding

Pauline McNeill (Glasgow Kelvin) (Lab): To ask the Scottish Executive, further to the answer to question S1W-2316 by Susan Deacon on 25 November 1999, in what way the cost to health boards of care provided under the negotiated reciprocal agreement is recognised within the total resources allocated to each health board each year.

Susan Deacon: A calculation was made in 1989-90 of the costs incurred on an all-Scotland basis for the care of those overseas visitors referred here for specific treatment or who fall ill while here on a visit. A similar calculation was carried out for Scottish residents treated abroad. The balancing sum was then allocated on a weighted capitation basis to all health boards and included in their general allocation. Although they are not separately identified, these funds continue to form part of each health board’s general allocation.

NHS Funding

Mr Duncan Hamilton (Highlands and Islands) (SNP): To ask the Scottish Executive to specify each health board’s real terms increase in funding for 2000-01 and 2001-02, compared with 1999-2000, expressed in both monetary and percentage terms.

Susan Deacon: The information requested is as shown in the following table:

  


Health Board
  

2000-01 Unified 
  Budget Real Terms Increase Over 1999-2000
  £000


2000-01 Unified 
  Budget Real Terms Increase in Funding Over 1999-2000 %


2001-02 Unified 
  Budget Real Terms Increase Over 1999-2000
  £000


2001-02 Unified 
  Budget Real Terms Increase in Funding Over
  1999-2000 %




Argyll & Clyde
  

9.923
  

2.84
  

24.813
  

6.94
  



Ayrshire & Arran
  

7.982
  

2.68
  

21.919
  

7.18
  



Borders
  

2.374
  

2.75
  

6.153
  

6.95
  



Dumfries & Galloway
  

3.342
  

2.67
  

8.225
  

6.40
  



Fife
  

7.873
  

3.04
  

20.242
  

7.63
  



Forth Valley
  

6.211
  

2.98
  

14.134
  

6.62
  



Grampian
  

10.032
  

2.68
  

24.189
  

6.31
  



Greater Glasgow
  

21.351
  

2.84
  

60.882
  

7.91
  



Highland
  

4.689
  

2.79
  

13.453
  

7.80
  



Lanarkshire
  

12.074
  

2.89
  

31.665
  

7.39
  



Lothian
  

15.766
  

2.84
  

40.613
  

7.13
  



Orkney
  

0.357
  

2.16
  

1.176
  

6.94
  



Shetland
  

0.491
  

2.49
  

1.166
  

5.78
  



Tayside
  

9.195
  

2.80
  

21.004
  

6.23
  



Western Isles
  

0.675
  

2.23
  

2.108
  

6.81
  



  Note: Unified Budgets for 2001-02 are indicative.

  These figures are based on allocations notified to health boards on 5 January and so do not include the additional resources of £173 million made available to the Health Budget which was announced in the Scottish Parliament on 30 March.

NHS Pay

Mr Duncan Hamilton (Highlands and Islands) (SNP): To ask the Scottish Executive what percentage of each health board’s estimated budget increase for the next three years will be taken up by the recent pay rise announcements by the Pay Review Bodies for Nurses, Midwives, Health Visitors and Professions Allied to Medicine and Doctors and Dentists, expressed in both cash and real terms.

Susan Deacon: Details of the estimated cost of the recent pay review body awards for individual health boards for the next three years are not available. The estimated costs of the pay awards nationally are £88.2 million, £89.9 million and £89.9 million in 2000-01, 2001-02 and 2002-03 respectively. These costs represent 32.3% and 29.1% of the estimated budget increases for 2000-01 and 2001-02 in cash terms or 54.3% and 46.9% in real terms. Health board budgets for 2002-03 have yet to be determined.

  These figures are based on allocations notified to health boards on 5 January and so do not include the additional resources of £173 million made available to the Health Budget which was announced in the Scottish Parliament on 30 March.

NHS Pay

Mr Duncan Hamilton (Highlands and Islands) (SNP): To ask the Scottish Executive whether it will detail, for the years 2000-01, 2001-02 and 2002-03, the pay offer for each section of staff within (a) the Nurses, Midwives, Health Visitors and Professions Allied to Medicine Pay Review Body and (b) the Doctors and Dentists Pay Review Body.

Susan Deacon: Pay increases for these staff groups are recommended on an annual basis by the independent Pay Review Bodies (PRB) and as such no offer for 2001-02 and 2002-03 has yet been made. For 2000-01, the PRBs recommended headline increases of 3.4% for nurses, midwives, health visitors and the professions allied to medicine and 3.3% for doctors and dentists. The Scottish Executive accepted these recommendations and implemented them in full with no staging.

Nutrition

Mrs Margaret Smith (Edinburgh West) (LD): To ask the Scottish Executive how many people admitted to hospital in Scotland in each of the last five years have had some degree of malnutrition.

Susan Deacon: This information is not available in the form requested. Malnutrition can mean both over-nourishment and under-nourishment. The 1995 Scottish Health Survey showed that, while only 6.9% of Scots in the 16-64 age group were classed as underweight, 51.4% were classed as either overweight or obese. A healthy and balanced diet combined with physical activity helps people to maintain appropriate body weight. The Scottish Executive is pursuing a range of initiatives to encourage and support people to make the lifestyle changes necessary to improve health.

Nutrition

Alex Neil (Central Scotland) (SNP): To ask the Scottish Executive how it monitors whether the Scottish Diet Targets are being achieved.

Susan Deacon: A number of sources are being utilised to monitor progress towards the dietary targets. These include the Scottish Health Survey, the UK National Food Survey, the UK Diet and Nutrition Survey and the Infant Feeding Survey. The work of the Food Standards Agency, which was established on 3 April, will also contribute to the monitoring of changes in the Scottish diet.

Nutrition

Mrs Margaret Smith (Edinburgh West) (LD): To ask the Scottish Executive how many people in Scotland are malnourished due to disease.

Susan Deacon: This information is not available.

Nutrition

Mrs Margaret Smith (Edinburgh West) (LD): To ask the Scottish Executive what measures it is taking to assess the prevalence and tackle the problems of malnutrition in hospitals and in the community.

Susan Deacon: Research on malnutrition in hospitals has been carried out over a number of years. It has had to take account of the complex effect of illness on nutritional status and distinguish between malnutrition caused by lack of nutritious food and that caused by the metabolic response to illness and injury. In the wider context, the Scottish Executive Health Department has issued guidance on core nutritional standards and has asked that they be applied in nursing homes and in all NHS care facilities. The Clinical Resources and Audit Group is at present funding an audit of the nutrition of elderly people and nutritional aspects of their care both in NHS and non-NHS settings. The audit report is expected in the summer.

  The Scottish Diet Action Plan provides the comprehensive framework within which we are tackling Scotland’s poor diet. Healthy eating initiatives aimed at schoolchildren, older people and the community as a whole are all in place. Working with the Health Education Board for Scotland, we have developed high profile health education campaigns and joint projects.

  We have identified low-income communities – which, overall, experience the poorest health – for particular attention. The Scottish Community Diet Project is among the many initiatives aimed at these communities. With the help of Scottish Executive funding of £0.5 million, the project is now beginning to make a major and positive impact on the diet and health of some of the most vulnerable people in our society. It recently received the Derek Cooper award for outstanding work in improving food in Britain.

  It is important to recognise that improvements can only be achieved if we tackle the poor life circumstances that underlie much of Scotland’s poor dietary and nutritional status. We are committed to doing that.

Nutrition

Mrs Margaret Smith (Edinburgh West) (LD): To ask the Scottish Executive what the prevalence of malnutrition is for people (a) under 15; (b) between 16 and 45; (c) between 46 and 65; (d) between 66 and 75 and (e) over 75 years, broken down by health board area.

Susan Deacon: This information is not available in the form requested. I would, however, refer you to my answer to your question S1W-5850.

Nutrition

Mrs Margaret Smith (Edinburgh West) (LD): To ask the Scottish Executive how nutrition policy, both for under- and over-nutrition, is co-ordinated between its different agencies and departments.

Susan Deacon: The Scottish Executive’s commitment to a co-ordinated approach to dietary improvement is being taken forward through the comprehensive framework provided by the Scottish Diet Action Plan, Eating for Health , and within the wider policies and structures which we are putting into place to tackle the root causes of poverty and social exclusion – key determinants of Scots’ poor dietary and nutritional status.

  The Executive’s holistic approach is exemplified by my intention to appoint a National Dietary Co-ordinator and by the Ministerial Poverty and Inclusion Task Force. The latter brings together all the ministerial portfolios which make a contribution to social inclusion, including health, education, employment, transport and rural affairs. Dietary and nutrition issues will be included as appropriate by the Task Force in its development and review of policy.

Nutrition

Mrs Margaret Smith (Edinburgh West) (LD): To ask the Scottish Executive what role nutrition plays in public health planning.

Susan Deacon: Improving the diet and nutritional status of the Scottish population is a key element of the Executive’s public health strategy. The White Paper, Towards a Healthier Scotland , sets out that strategy, which was endorsed by the Scottish Parliament last September.

  The White Paper identified diet as one of five lifestyle behaviours for priority action and confirmed the continued implementation of the Scottish Diet Action Plan, Eating for Health, as the appropriate way forward to bring about essential dietary improvement. Currently, I am exploring with relevant interests how best to give further impetus to this work.

Nutrition

Mrs Margaret Smith (Edinburgh West) (LD): To ask the Scottish Executive whether there have been any assessments of any savings which the NHSiS could make by ensuring that all malnourished patients receive adequate nutrition intervention.

Susan Deacon: No assessments of this kind have been made.

Nutrition

Mrs Margaret Smith (Edinburgh West) (LD): To ask the Scottish Executive whether there are any plans to make routine nutritional screening an integral part of patient care.

Susan Deacon: There are no plans for a formal screening programme. Doctors, nurses (including district nurses) and health visitors routinely take nutritional factors into account as part of medical and nursing examinations in hospital or primary care settings. GPs can prescribe nutritional supplements where appropriate.

Nutrition

Mrs Margaret Smith (Edinburgh West) (LD): To ask the Scottish Executive whether there are any currently available guidelines on the identification, treatment and management of malnutrition in the community.

Susan Deacon: There are no guidelines specifically targeted at malnutrition in the community. In 1999, the Scottish Executive Health Department set out an action plan for nursing homes requiring them to assess the nutritional status of residents and provide for dietary needs in line with UK Department of Health Dietary Reference Values. The plan made it clear that health boards and NHS Trusts should apply the same standards in all NHS facilities. The Nursing, Midwifery and Health Visiting Advisory Committee is at present working to implement the plan throughout the NHS, including in primary care settings.

  The Clinical Resources and Audit Group is also funding an audit of the nutrition of elderly people and nutritional aspects of their care in NHS and non-NHS settings. Its report is expected in the summer.

Nutrition

Mrs Margaret Smith (Edinburgh West) (LD): To ask the Scottish Executive whether the new Food Standards Agency will have a role in monitoring malnutrition.

Susan Deacon: The Food Standards Agency Scotland will share responsibility with the Scottish Executive Health Department for ongoing surveillance of the nutritional status of the population. The agency will also be responsible for monitoring the nutrient content of food and will provide advice on the diet as a whole, including the definition of a healthy diet.

Police

Shona Robison (North-East Scotland) (SNP): To ask the Scottish Executive how many probationary police officers from an ethnic minority background leave the police force before the end of their probationary period, as a proportion of the total number of officers leaving during their probationary period.

Mr Jim Wallace: Over the past five years, a total of 179 probationary police officers have left the Scottish police service before the end of their probationary period. Two of these were from an ethnic minority background.

Police

Mrs Margaret Smith (Edinburgh West) (LD): To ask the Scottish Executive whether it will publish, for each police force, the number of complaints made against senior police officers by members of the public for the period 1 May 1999 to 31 March 2000.

Mr Jim Wallace: Complaints against senior police officers i.e. assistant chief constable and above, are dealt with by the police authority for the force concerned. The information requested is as follows:

  


Central Scotland Police
  

Nil
  



Dumfries & Galloway Constabulary
  

Nil
  



Fife Constabulary
  

Nil
  



Grampian Police
  

1
  



Lothian & Borders Police
  

3
  



Northern Constabulary
  

Nil
  



Strathclyde Police
  

3
  



Tayside Police
  

Nil

Police

Nick Johnston (Mid Scotland and Fife) (Con): To ask the Scottish Executive, further to the answer to question S1W-5040 by Mr Jim Wallace on 31 March 2000, whether it will provide a breakdown of its funding and police authority funding of the Scottish Police College for each of the last four years.

Mr Jim Wallace: The breakdown of Scottish Executive funding and police authority funding for the Scottish Police College is as follows:

  

 

2000-01 Estimate 
  £000
  

1999-2000 Forecast 
  Outturn £000
  

1998-99 Outturn
  £000


1997-98 Outturn
  £000




Scottish Executive
  

3,574
  

3,525
  

3,440
  

4,170
  



Police Authorities
  

3,669
  

3,614
  

3,505
  

4,222
  



Total
  

7,243
  

7,139
  

6,945
  

8,392*
  



  *The funding for 1997-98 included the final tranche of a major capital building programme at the college.

Port Authorities

Maureen Macmillan (Highlands and Islands) (Lab): To ask the Scottish Executive whether it will list the members of the board of the Cromarty Firth Port Authority.

Sarah Boyack: There are seven members of the Board of Cromarty Firth Port Authority namely:

  Mr Peter Grant, CBE (Chairman)

  Mr Roy MacGregor

  Mr Allan Whiteford

  Mrs Val MacIver

  Mr Alexander MacKenzie

  Mr Jamie Stone MSP

  Mr Rod Johnstone, Chief Executive

  Mr Rod Johnstone, the Chief Executive was co-opted to the Board following the resignation of Mr Tony Knight on 7 January 2000.

Prostitutes

Dorothy-Grace Elder (Glasgow) (SNP): To ask the Scottish Executive, further to the answer to question S1W-4117 by Susan Deacon on 15 February 2000, whether it will specify the exact number of prostitutes in Glasgow who inject drugs and are HIV positive.

Iain Gray: Since women are not required to identify themselves as prostitutes, precise information is not available.

Rape

Mr Gil Paterson (Central Scotland) (SNP): To ask the Scottish Executive what reassurances it can give, and what measures it is taking to ensure that there is no reduction in the sentences of convicted rapists unless offenders actively participate in programmes for positive change while in custody.

Mr Jim Wallace: The Scottish Executive is committed to providing opportunities to allow prisoners to take responsibility for their offending behaviour and take steps to reduce the risk of re-offending following release. Under current sentence management arrangements, most prisoners convicted of serious sexual offences spend a large part of their sentences in Peterhead Prison. The Scottish Prison Service has developed a variety of intervention programmes aimed at addressing offending behaviour. It is introducing this month, at Peterhead, STOP 2000, an accredited programme - developed by HM Prison Service in England and Wales - that is designed specifically for sex offenders. The assessment process for STOP 2000 identifies those prisoners in most need and targets those who present the greatest risk of re-offending. It is proposed to introduce the programme at HMP Edinburgh and HMP Barlinnie later this year.   The adoption of the programme by the Scottish Prison Service will allow a UK-wide approach to be taken to dealing with sex offenders while they are in custody.

  So far as the early release of such prisoners is concerned, a long-term prisoner (that is one sentenced to four years or more) may be granted early release on licence if this is recommended by the Parole Board once he or she has completed one-half of his or her sentence. In it’s review of a long-term prisoner’s case, the board’s function is primarily to assess the risk that the prisoner would present to public safety if released early on parole. In making its assessment, it takes into account a variety of factors including the nature of the offence, the prisoner’s conduct and response in custody and his or her home circumstances. The board and Scottish Ministers, in those cases in which the latter exercise discretion over release, consider very carefully reports on the steps that a prisoner has taken to address his or her offending behaviour and whether their participation in, and response to, offence-related programmes suggests a reduction in risk.

Regional Selective Assistance

Alex Neil (Central Scotland) (SNP): To ask the Scottish Executive how many businesses in each local enterprise company area are waiting for approval for Regional Selective Assistance and what the average waiting time is per area.

Henry McLeish: Some 163 RSA applications were received prior to the expiry of the Assisted Areas map in December 1999. This compares with 253 applications for the whole year to December 1998. The bulk of these applications have been dealt with but we have yet to reach a final decision on 71. In addition, we have had a further 26 Regional Selective Assistance applications this year. We are able to appraise these applications but will not be in a position to make an offer of Regional Selective Assistance until the new Assisted Areas map is approved by the European Commission. The table below shows these applications by Scottish Enterprise Area.

  


Scottish Enterprise Network


Applications 
  received 1999 – decision outstanding


Applications 
  received in 2000




Scottish Enterprise Ayrshire
  

6
  

6
  



Scottish Enterprise Borders
  

0
  

0
  



Scottish Enterprise Dumfries and 
  Galloway
  

0
  

0
  



Scottish Enterprise Dunbartonshire
  

5
  

0
  



Scottish Enterprise Edinburgh and 
  Lothian
  

10
  

0
  



Scottish Enterprise Fife
  

5
  

3
  



Scottish Enterprise Forth Valley
  

1
  

2
  



Scottish Enterprise Glasgow
  

17
  

6
  



Scottish Enterprise Grampian
  

0
  

0
  



Scottish Enterprise Lanarkshire
  

15
  

4
  



Moray, Badenoch and Strathspey 
  Enterprise
  

0
  

0
  



Scottish Enterprise Renfrewshire
  

4
  

4
  



Scottish Enterprise Tayside
  

8
  

1
  



  Normally a decision is reached on most RSA applications within 40 working days of receipt and this doesn’t differ significantly by area. However, given the exceptionally large number of applications received prior to the expiry of the previous Assisted Areas map, the Scottish Executive has been unable to maintain the usual application processing times.

Scottish Health Technology Assessment Centre

Mary Scanlon (Highlands and Islands) (Con): To ask the Scottish Executive whether new and existing drugs and treatments will be assessed by the Scottish Health Technology Assessment Centre on the basis of affordability or cost-effectiveness.

Susan Deacon: The Health Technology Board for Scotland will assess new and existing drugs and treatments solely on the evidence of their clinical and cost-effectiveness.

Scottish Health Technology Assessment Centre

Mary Scanlon (Highlands and Islands) (Con): To ask the Scottish Executive whether the Scottish Health Technology Assessment Centre’s advice on new and existing health technologies will be based on cost/benefit analysis and, if so, whether it will define the parameters of that analysis.

Susan Deacon: Among the first tasks of the new Health Technology Board for Scotland will be to establish and obtain wide agreement to the methodology it will use to assess the clinical and cost-effectiveness of new and existing health technologies.

Scottish Health Technology Assessment Centre

Mary Scanlon (Highlands and Islands) (Con): To ask the Scottish Executive how the Scottish Health Technology Assessment Centre will contribute to equality of access to healthcare throughout Scotland.

Susan Deacon: The Health Technology Board for Scotland will be a single source of evidence-based advice on the clinical and cost-effectiveness of treatments and drugs. It will work closely with the NHS and patient representatives to ensure that effective innovations move quickly into mainstream practice, so ensuring that all the people of Scotland have access to the most effective treatment available.

Scottish Health Technology Assessment Centre

Mary Scanlon (Highlands and Islands) (Con): To ask the Scottish Executive what role health boards will have in the decisions made regarding the availability of medicines in the NHS given the input from the Scottish Health Technology Assessment Centre and whether all boards will be obliged to adopt their recommendations.

Susan Deacon: The Health Technology Board for Scotland will be a single source of evidence-based advice to health service decision-makers on the clinical and cost-effectiveness of new and existing health technologies. Health boards will take account of the new board’s advice to ensure that the people they serve have access to the most effective healthcare and treatment available.

Scottish Health Technology Assessment Centre

Mary Scanlon (Highlands and Islands) (Con): To ask the Scottish Executive whether it will take action against health boards that do not provide all the drug and treatment therapies recommended by the Scottish Health Technology Assessment Centre and, if so, what that action will be.

Susan Deacon: Health boards will take account of the advice of the Health Technology Board for Scotland in reaching their decisions. They will also be expected to justify any decision not to follow the advice of the new board, both in the public eye (the advice of the board will be public) and within the context of clinical governance.

Scottish Health Technology Assessment Centre

Mary Scanlon (Highlands and Islands) (Con): To ask the Scottish Executive whether it will require health boards to provide all the drugs and treatment therapies recommended by the Scottish Health Technology Assessment Centre.

Susan Deacon: The Health Technology Board for Scotland will provide boards with advice on the clinical and cost-effectiveness of new and existing treatments. Boards will be expected to take account of that advice in the decisions they make about the availability of treatments. Boards will also be expected to justify any decision not to follow the advice of the new board, both in the public eye (the advice of the board will be public) and within clinical governance.

Scottish University for Industry

Fergus Ewing (Inverness East, Nairn and Lochaber) (SNP): To ask the Scottish Executive whether it will consider locating the Scottish University for Industry in Inverness and, if so, whether it could be linked with the University of the Highlands and Islands.

Henry McLeish: I announced to Parliament on 13 April that the Europa Building, in Glasgow’s Argyle Street, has been chosen as the location for the Scottish UfI’s headquarters. Scottish UfI Ltd, which expects to recruit around 25 staff in all, is likely to occupy the building from the end of May.

  The Scottish UfI will act as a broker, not a provider of learning. It will stimulate the demand for learning and for providers that will mean rising to the challenge of providing learning where, when and in the format it is needed. The link to the proposed new higher education institution UHI, when it is established, will be the same as with any other higher education institution wishing to supply learning. Scottish UfI Ltd is already actively engaged in building strong partnerships with education and training providers and is collaborating with the University of the Highlands and Islands Project, sharing what works and what does not, where access to more advanced learning opportunities and qualifications is concerned.

Smoking

Mr Kenneth Gibson (Glasgow) (SNP): To ask the Scottish Executive which hospitals use laser treatments, paid for by the NHS, to help people to give up smoking; what the success rate is of such treatment; what the average cost is of such treatment and whether it plans to extend the availability of this treatment on the NHS.

Susan Deacon: The information requested is not available centrally.

  It is for health boards and NHS Trusts to plan and deliver services which meet the need of their local population. In doing so, they take account of the effectiveness of different healthcare interventions, including laser treatment.

  The Scottish Executive is, of course, taking forward a range of measures to reduce the levels of smoking by people in Scotland. These include health education and promotion activities such as Smokeline, targeted help for groups such as pregnant women and targeted smoking cessation services and nicotine replacement therapy, which is available free of charge to those least able to afford it.

Utilities Bill

Fergus Ewing (Inverness East, Nairn and Lochaber) (SNP): To ask the Scottish Executive whether it will make representations to Her Majesty's Government opposing the proposals in the Utilities Bill that the existing area electricity consumer committees be abolished and replaced with a single Gas and Electricity Consumer Council for the whole of the UK.

Henry McLeish: The Executive does not propose to make such representations. Under the provisions of the Utilities Bill, the new council must establish one or more committees of the council for areas in Scotland and must also maintain at least one office in Scotland at which consumers may apply for information.

Water Charges

Fergus Ewing (Inverness East, Nairn and Lochaber) (SNP): To ask the Scottish Executive whether it will introduce a rebate for water charges similar to that available to council tax payers in order to help those with the least ability to pay.

Sarah Boyack: Water and sewerage charges, in common with other utility charges, cover the provision of specific services. They are not taxes and it would not be appropriate to treat them as such by introducing rebates for them. I have, however, asked my officials to consider if we can improve on the protection that the current charging arrangements provide for many of those with the least ability to pay.